Endocrine Abstracts

We live in a world where neurosurgeons still prescribe salt tablets and fludrocortisone for hyponatraemia, and think cerebral salt wasting syndrome happens on a weekly basis. Neurosurgeons clearly need help, and the world of endocrinology needs to stage an interventionPituitary surgery is almost exclusively based in tertiary referral centres where neurosurgical departments are sited, often with en...

Background: Pre-pituitary surgery, patients attend a ‘Pre-Pituitary Surgery Clinic’ (PPSC), to discuss management options and risks. Clinicians in attendance are; pituitary surgeon (1) registrar (1) endocrine team consultants (1–3), registrars (1–2) nurses (1) senior house officer (1) visiting doctors/medical students (4–6). Patients are informed a number of clinicians attend the clinic due to the multidisciplinary nature (MDT) and unit teaching respon...

Objectives: Reducing length of inpatient stay following trans-sphenoidal pituitary adenectomy (TSA) could create significant financial saving for the NHS. We assessed early complication rates post-TSA to determine feasibility of early hospital discharge (3 days) post-TSA.Methods: We identified retrospectively 60 patients who underwent TSA at the John Radcliffe Hospital. These consisted of patients with a pre-operative confirmed diagnosis of non-functioni...

Objective: There is little data on suprasellar meningiomas regarding their effect on pituitary hormones and outcome following surgical intervention.Methods: In a database of patients undergoing surgical treatment for a pituitary mass set up in 1997, all cases of histologically proven meningioma were identified. Medical records were reviewed in order to determine menigioma site, size, pre- and postoperative vision as well as pre- and postoperative pituita...

Background: Short Synacthen test (SST) is commonly used for the assessment of the hypothalamus-pituitary-adrenal (HPA) axis after pituitary surgery. In our centre, patients are discharged on hydrocortisone on day 3 post-surgery and 9am cortisol on day 8 post-surgery is measured. Hydrocortisone is stopped if cortisol is ≥350 nmol/L on day 8. Six weeks post-surgery SST is performed and treatment adjusted. We aimed to assess the perfor...

This 22 year old lady presented with Haemophilus Influenza meningitis. Given an unusual organism, she had an MRI which revealed an incidental pituitary macroadenoma extending into the right cavernous sinus and breaching the anterioinferior wall of the pituitary fossa. Thyroid function showed raised T4 (24.7 pmol/L) and T3 (8.3 pmol/L) with unsuppressed TSH (1.75 munit/L). IGF-1 was also raised at 56.7 nmol/L (12–50.1 nmol/L).<p c...

Background: Short Synacthen test (SST) is commonly used for the assessment of the hypothalamus-pituitary-adrenal (HPA) axis after pituitary surgery. In our centre, patients are discharged on hydrocortisone on day 3 post-surgery and 9am cortisol on day 8 post-surgery is measured. Hydrocortisone is stopped if cortisol is ≥350 nmol/L on day 8. Six weeks post-surgery SST is performed and treatment adjusted. We aimed to assess the perfor...

This 22 year old lady presented with Haemophilus Influenza meningitis. Given an unusual organism, she had an MRI which revealed an incidental pituitary macroadenoma extending into the right cavernous sinus and breaching the anterioinferior wall of the pituitary fossa. Thyroid function showed raised T4 (24.7 pmol/L) and T3 (8.3 pmol/L) with unsuppressed TSH (1.75 munit/L). IGF-1 was also raised at 56.7 nmol/L (12–50.1 nmol/L).<p c...

The aim: To examine the case of relapse, the growth of non-functional pituitary macroadenoma (NFPA).Material and methods: Under our supervision was a patient Bekieva Karomat, born in 1985 with the diagnosis: Macroadenoma of the pituitary gland with a total growth option. (NFPA) State after the transnasal hypophysisectomy (23.01.08, TGE). Continued growth of the tumor. Re TGE (26.11.11). Hypopituitarism. Secondary hypogonadism, secondary hypocorticism, se...

Context: Disease processes that affect the pituitary stalk are broad, ranging from indolent lesions requiring simple observation to severe lesions with significant implications. Diagnosis and management of these lesions remains unclear.Objective: The aim of this study was to assess the clinical presentation, biochemical and pathology characteristics of pituitary stalk thickening lesions and their association with specific MRI features in order to provide...